Provider Demographics
NPI:1114104270
Name:GREENWOOD-WRIGHT, VICKI R
Entity Type:Individual
Prefix:MISS
First Name:VICKI
Middle Name:R
Last Name:GREENWOOD-WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 YOE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-3837
Mailing Address - Country:US
Mailing Address - Phone:832-272-4174
Mailing Address - Fax:713-633-5448
Practice Address - Street 1:7261 YOE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016
Practice Address - Country:US
Practice Address - Phone:832-272-4174
Practice Address - Fax:713-633-5448
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X
TX159259164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No251C00000XAgenciesDay Training, Developmentally Disabled Services